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腹部无切口经肛门切除标本的腹腔镜低位直肠癌根治套入式吻合保肛术 被引量:15

Transanal laparoscopic radical resection with telescopic anastomosis for low rectal cancer
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摘要 目的:探讨腹部无切口经肛门切除标本的腹腔镜低位直肠癌根治套入式吻合保肛术的安全性、可行性及临床疗效。方法总结2010年1月至2014年9月北京军区总医院普通外科对37例肿瘤距肛缘4~7 cm的直肠癌患者施行腹部无切口经肛门切除标本的腹腔镜直肠癌根治套入式吻合保肛术的临床资料。术前评估26例为T1N0M0期,11例为T2N0M0期。结果全组患者均顺利完成手术。手术时间(178±21) min,术中出血量(76±11) ml,检出淋巴结(13±7)枚,术后肛门排气时间为(3.0±1.2) d,均未发生与手术相关并发症,术后(12.0±4.2) d出院。术后12月肛门功能检测结果显示,Kirwan分级1级者占94.6%(35/37),肛门功能基本恢复到正常;术后随访3~45个月,无肿瘤复发。结论腹部无切口经肛门切除标本的腹腔镜低位直肠癌根治套入式吻合保肛术安全可行,临床疗效满意。 Objective To assess the safety, feasibility and clinical outcome of laparoscopic radical resection for low rectal cancer with telescopic anastomosis or with colostomy by stapler through transanal resection without abdominal incisions. Methods From January 2010 to September 2014, 37 patients underwent laparoscopic radical resection for low rectal cancer through transanal resection without abdominal incisions. The tumors were 4-7 cm above the anal verge. On preoperative assessment , 26 cases were T1N0M0 and 11 were T2N0M0. Results For all cases, successful surgery was performed. In telescopic anastomosis group, the mean operative time was (178±21) min, with average blood loss of (76±11) ml and (13±7) lymph nodes harvested. Return of bowel function was (3.0±1.2) d and the hospital stay was (12.0±4.2) d without postoperative complications. Patients were followed up for 3-45 months. Twelve months after surgery, 94.6%(35/37) patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal. Conclusions Laparoscopic radical resection for low rectal cancer with telescopic anastomosis or colostomy by stapler through transanal resection without abdominal incisions is safe and feasible. Satisfactory clinical outcome can be achieved mini-invasively.
出处 《中华胃肠外科杂志》 CAS CSCD 北大核心 2015年第6期581-583,共3页 Chinese Journal of Gastrointestinal Surgery
关键词 直肠肿瘤 低位 腹腔镜 根治手术 腹部无切口 Rectal neoplasms,low Laparoscopy Radical resection No abdominal incision
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  • 1李世拥.努力提高直肠癌外科治疗水平[J].解放军医学杂志,2006,31(9):847-850. 被引量:27
  • 2邰建东,刘玉石,王广义.直肠癌保肛术后发生吻合口瘘的影响因素及其处理[J].中华胃肠外科杂志,2007,10(2):153-156. 被引量:83
  • 3李世拥.进一步加强结直肠癌外科规范化治疗[J].中华外科杂志,2007,45(7):433-435. 被引量:22
  • 4Degiuli M,Mineccia M,Bertone A,at el.Outcome of laparoscopic colorectal resection.Surg Endosc,2004,180(3):427-432.
  • 5Kishimoto Y,Araki Y,Sato Y,et al.Functional outcome after sphincter excision for ultralow rectal cancer.Int Surg,2007,92(1):46-53.
  • 6Guerriero O,Tufano G,Pennetti L,et al.Sphincter-saving surgery in low rectal cancer.Chir Ital,2006,58(1):83-92.
  • 7Chin CC,Huang WS,Yeh CH,et al.Performing handsewn coloanal anastomosis with the pursestring suture anoscope.Dis Colon Rectum,2008,51(9):1430-1431.
  • 8Liang JT,Lai HS,Lee PH,et al.Comparison of functional and surgical outcomes of laparoscopic-assisted colonic J-pouch versus straight reconstruction after total mesorectal excision for lower rectal cancer.Ann Surg Oncol,2007,14(7):1972-1979.
  • 9Kishimoto Y, Araki Y, Sato Y, et al. Functional outcome after sphincter excision for uhralow rectal cancer. Int Surg, 2007,92 ( 1 ) : 46-53.
  • 10Guerriero O, Tutano G, Pennetti L, et al. Sphincter-saving surgery in low rectal cancer. Chir Ital, 2006,58 (1):83-92.

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  • 1杨菜芳,罗生蕊,堵玉凤.低位直肠癌腹腔镜括约肌间切除术保肛治疗体会及护理[J].医学信息(医学与计算机应用),2016,29(33):41-42. 被引量:2
  • 2杜晓辉,方国吉,宁宁,马冰,杨华夏,刘庆,张鼎.腹腔镜直肠癌全直肠系膜切除术的学习曲线研究[J].中华腔镜外科杂志(电子版),2013,6(1):12-14. 被引量:20
  • 3杨光.保肛手术治疗老年低位直肠癌的临床观察[J].实用癌症杂志,2014,29(3):295-297. 被引量:10
  • 4Qian-Lin Zhu,Bo Feng,Ai-Guo Lu,Ming-Liang Wang,Wei-Guo Hu,Jian-Wen Li,Zhi-Hai Mao,Min-Hua Zheng,Department of General Surgery,Shanghai Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China,Shanghai Minimally Invasive Surgery Center,Shanghai 200025,China.Laparoscopic low anterior resection for rectal carcinoma:Complications and management in 132 consecutive patients[J].World Journal of Gastroenterology,2010,16(36):4605-4610. 被引量:24
  • 5Liu C,Zheng Y, Yang X, et al. Radical correction for Budd -Chiari syndrome through a transabdominal approach [ J ]. Ann Vasc Surg, 2011 ;25(5) :702-706.
  • 6Yu D S,Huang X E,Zhou J N. Comparative study on the value of a- nal preserving surgery for aged people with low rectal carcinoma in Jiangsu, China [ J ]. Asian Pac J Cancer Prev, 2012,13 ( 5 ) : 2339- 2340.
  • 7Ding C, Wang C, Dong A, et al. Anterolateral minithoracotomy versus median sternotomy for the treatment of congenital heart defects: a meta- analysis and systematic review [ J]. J Cardiothorac Surg, 2012,7:43.
  • 8Welsch T, Mategakis V, Contin P, et al. Results of extralevator abdominoperineal resection for low rectal cancer including quality of life and long-term wound complications [ J ]. Int J" Colorectal Dis, 2013,28 (4) :503-510.
  • 9Zauber AG, Winawer SJ, O' Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths [J]. N Engl J Med,2012,366(8) :687-696.
  • 10Rokavec M, oner MG, Li H, et al. IL~6R/STAT3/miR-34a feed- back loop promotes EMT-mediated colorectal cancer invasion andmetastasis [ J ]. J Clin Invest,2014,124 (4) : 1853 -1867.

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